In any society, the loss of human life cannot be remedied.
Saving lives, therefore, is a high priority for health systems.
In many cases, scientific advancement and timely action can combine to save lives.
Innovations in health systems that go hand in hand with emerging technologies are required
to save preventable deaths.
Death of a mother or a newborn during childbirth, in particular, is a devastating loss that
affects the whole family.
In Pakistan, over the last 30 years, valuable efforts have been made to develop a public
health system and enhance its outreach in rural areas.
As a result of these efforts, the number of mothers and newborns dying during childbirth
has reduced, but still, the number of such preventable deaths remains unacceptably high.
Pakistan is one of the six countries that contribute more than half of all maternal
deaths in the world, and the risk of death during the pregnancy remains as high as one
in six compared to one in 30,000 in northern Europe.
Moreover, Pakistan has the third-largest number of newborn deaths, with infant mortality
and under-five mortality remaining as high as 66 and 81 per 1,000 live birth in 2015.
Of course, both maternal and neonatal deaths are preventable by improving the access to
healthcare system, by providing relevant information, by referring to appropriate facilities in
case of complications, and by decreasing the transportation costs to these facilities.
Recognizing the scientific potential for saving lives, a team of academics and practitioners
carried out an innovative effort in 2015 and 2016 by the name of Affordable Technology
Project.
This project was initiated and implemented by a team of Georgia State University of
United States and Khyber Medical University of Pakistan in collaboration with the Government
of Punjab and the Government of Khyber Bakhtunkhwa.
For this purpose, two different areas were selected.
District Chakwal is located in Punjab Province and District Sawabi in Khyber Bakhtunkhwa.
This selection was to study the implementation of this Affordable Technology Project in different
economic and cultural backgrounds and carry out context-specific refinement in light of
the results.
The purpose of Affordable Technology was saving maternal and infant lives, in which every
woman in the world, whether she is a student or a caretaker, whether she is in a difficult
or difficult situation, is through mobile phone technology, the health of her mother and
child, and the critical information to be sent to the healthcare system without any
delay.
We should know that the development of the public healthcare system is present, but due to
social or social issues, women and their families cannot reach this healthcare system.
Therefore, most of the time, the loss of life is significantly reduced by the end of the
year.
When I was about to give birth to my daughter, I was at work, so I got late for work.
We didn't have anything, we didn't have a mobile phone, so I got the rate, I called the
people late, they were late, so I put them in the ambulance and kept going on the way.
You know how difficult it is for people to reach such a poor person, so you have to
spend 200,000 rupees to reach such a poor person, so the way I am running my own house, or
other than my wife, I know what is going on with me, if someone has a headache, I will
sit with him for a while and tell him that he has a headache, if he has a headache,
then I will know that he had such a headache yesterday.
I haven't done any sports, I have been through a lot, these are my children who have
The main problem is that she doesn't have proper sterilization or proper instruments.
She just takes her own things and delivers them to her home.
When it comes to an untrained child, she doesn't even have the knowledge that what she will do in the future.
For example, when it comes to just a PPH where a woman is bleeding a lot after the baby or she has problems,
she can't cover up at all.
And at last, the patient comes to her death.
The Affordable Technology Project introduced a wonderful system for these women with the Government's primary healthcare system
so that despite the lack of education and convenience, they can be given a beneficial treatment.
At this point, the first impression of this project was that the women in the village
were heard in their own language.
My elder daughter was born here.
So my in-laws called my uncle and took me home.
And I had a very difficult time at that time.
But now that I have come back from Lahore, the doctors have continued to contact me.
They have been telling me that this is a problem and that I have been calling them.
When my daughter was born again, I went to the hospital with the doctor.
When I went to the hospital, my daughter took me to my in-laws.
After three months, she gave me a child and I had a case of that too.
Because of my mother-in-law and my in-laws, my in-laws decided to go to the hospital.
I went to the hospital.
I had a raffle at the hospital.
My daughter had a big operation there.
She took me there and took me there.
Asadi, one of the five people in the village was a patient.
One of the five people gave her the case.
She was blindfolded.
My daughter had a pretty smug look while I was five.
There were no teeth on her.
When we got my child done, we found out that they would do anything outside that let her go.
The advantage of this is that when women contacted me,
they told me that we were getting a computer call on our mobile.
I have been getting calls for a year.
First about my health, then about my daughter's health.
First we wanted to deliver at home.
Then when I started getting calls, we said that we would deliver from the hospital.
In the affordable technology project, when we started sending the subject a rubo call,
we had different kinds of issues.
For example, some subjects said that we had a call from this time to this time.
We called them at that time, during a specific time period.
Some said that we had a call, but we could not hear it.
We were busy in some work.
When your calls come, we cannot receive them, so you call us again.
So we have presented a solution for that.
Until we receive our calls, we keep calling them.
When the system was changed, we started calling again.
From 10th June 2015 to 10th June 2016, in 52 weeks, we called 73,145 calls.
Out of those, 59,945 calls were heard.
Let me tell you one more thing, there were 24,000 calls before the child message.
Alhamdulillah, people heard that as well.
The second important issue of the affordable technology for saving maternal and infant lives was call-in referrals.
The purpose of call-in referrals was to wait for the change in human resources without
reaching the health services of missing women.
This year, after the complete test, these women were preferred.
In this year, the
MIR, NERS and Gynecologist's area was assessed by these patients.
They were told that for safe delivery, when and why it is necessary to go to any nearby health facility.
Then, I got a call from Lahore.
They saved me from the third child.
I told them that I have to go to the hospital, I have to go here, I have to give birth to a child.
I don't have to go to the hospital.
They called me and told me that I have to go to the hospital immediately.
According to our history, this health service was held for the first time in many areas.
The call-in referrals were held for 1,002 women through call-in referrals.
In addition, 239 women were given information about the health of the women.
So that they can go to the health facility on the right path.
In the call-in referral, we had designed a dashboard with four different steps.
The first step was to talk to the subject and fill a form with its basic medical history.
That form would go to the gynecologist.
The gynecologist would see that form.
If he understood it was necessary, he would talk to the subject and take more information.
Otherwise, he would put his comments on the form of LHB and pass it on to RHS.
The work of RHS was that he would see the form.
He would see LHB and gynecologist's comments.
He would see his comments and divide the form into four different categories.
Red, Orange, Maroon and Purple.
And this form would go to the water manager.
The basic work of the water manager was that he would make sure that if someone had a water issue, he would get the money.
Despite the call-in referral, we had the hope that the family of women would not be taken to an appropriate hospital.
That's why we adopted a stand-by ambulance.
The purpose of this stand-by ambulance was to make the government healthcare system more effective.
And under this system, 14 women were taken to the hospital through emergency evacuation.
When my third daughter was born, I was in such a condition that I could not even go to my local hospital.
It was impossible to travel by bike or by car.
I called the helpline people and they gave me an ambulance. And at that time, I was praying for them.
They gave me an answer in the hospital because I was not a doctor.
I had to go to Chakwal because there was no doctor in our area.
The fourth phase of the affordable technology project was introduced by 24x7, one mother health plan.
The purpose of this was to call the women at any time on the mother health plan and take any information about their health or their child's health.
As a result, we received 42,000 calls from 9th December 2015 to 10th June 2016.
In which, the women of the village asked about their pregnancy and they were given their answers.
When I was going to be pregnant with my baby, I found out that I used to get information from the helpline.
I used to get very good information from the helpline.
The way I used to ask questions, I used to get information from the helpline.
The first thing that I was able to continue at that time, I did not know about the treatment.
So I got that information from the helpline people because of which I have been very well.
The project was conducted as a randomized controlled trial.
The research design was adopted to evaluate the impact of health systems interventions carefully.
It was implemented over 411 villages in the two districts of Pakistan.
The variety of outcomes were said yet, including the behavior response of households to receiving health messages.
But the key outcome of interest was the adoption of secured birth attendance at birth.
The results are at statistically significant levels.
Receiving health messages at a frequency of 2 times a week has a statistically significant and positive impact on adoption of secured birth attendance at birth.
The data will reveal more results that we hope will be very useful for policy solutions and for saving lives.
The results show that the women who received recorded health literacy messages twice a week,
timed with the gestation age, for them, the probability of adopting a skilled birth attendant for delivery was 2 times higher than the control group.
In the same way, specific advice given to women in villages through call-in referrals leads to a probability of adopting skilled birth attendance that is 4.7 times higher.
And the probability of going to a secondary or tertiary care hospital that is 3.3 times higher in comparison with the control group.
These results are statistically significant.
According to WHO and the Government of Pakistan, if a skilled birth attendant is delivered on time,
many mothers and children can be saved.
In the Affordable Technology Project, we were able to prove that in one year,
nearly 600 rupees were added to health care systems for the women who were attacked.
In the process of stopping the preventable deaths of both children,
science has been adopted.
In 2015, the United Nations adopted Sustainable Development Goals.
Pakistan also adopted these Aluminum Goals.
According to Sustainable Development Goals,
the number of women who received at least 1.7 lakhs from the population of Zajki in 2013 is at least 1.7 lakhs.
Whereas in Pakistan, the number of mothers at the time is at least 1.7 lakhs.
The number of women who received at least 1.7 lakhs from the population of Zajki in 2013 is at least 1.7 lakhs.
Whereas in Pakistan, the number of women at the time is at least 1.7 lakhs.
According to the Affordable Technology Project,
how will we try to reach the Sustainable Development Goals of the mother and the child?
The Affordable Technology Project is very important.
It is very easy to make them a part of the public health system.
If this scientific solution is tele-made according to the situation in Pakistan,
if they are accepted,
then in Pakistan, soon,
to save thousands of mothers and children,
they will be able to achieve the goals of health.
